Changes in Sagittal Spine Posture and Flexibility on Adolescents

February 4, 2019 updated by: Noelia González-Gálvez, Universidad Católica San Antonio de Murcia

Effectiveness of Pilates on Sagittal Spine Posture, Flexibility, Back Pain, Quality of Life and Anthropometrics Variables on Adolescents: A Randomized Controlled Trial

Several research show a high prevalence of spinal misalignments and a lack of stability of the spine in the adolescent population. In addition, back pain in adolescents is correlated with a longer time spent in sedentary activities, less time of physical activity, higher BMI, body fat percentage and / or the waist-hip index.

Therefore, the main aim of this project were assess the effect of a 10-minute Pilates program carried out in the final part of the Physical Education sessions for 4.5 months and 9 months on back pain, quality of life, sagittal spine curvature, hamstring extensibility, BMI, body fat percentage and the waist-hip index.

The present research will be elaborated by a quasi-experimental design, with experimental group (GE) and control group (CG); with pre-test, intermediate and post-test.

The inclusion criteria will be: a) being in Compulsory Secondary Education; b) not present any musculoskeletal, neurological, cardiological, metabolic, rheumatic or previous history of spinal pathologies or with previous treatment; c) be active in the sessions of Physical Education.

It was assessed back pain with Back Pain Survey in adolescents. Quality of life was assessed through the Kidscreen-27 questionnaire. To assess the sagittal spinal curvatura (in several positions) the Spinal Mouse System (Idiag, Fehraltdorf, Switzerland) was used.

The extensibility of hamstring muscle was assessed with seat and reach test, toe touch test and active and passive straight leg raising test.

The sedentary lifestyle as well as the level of physical activity will be evaluated through the Adolescent International Physical Activity Questionnaire (IPAQ).

The body mass index will be obtained by recording weight and height (BMI = Weight (kg) / height (cm) 2).

The waist-hip ratio is the quotient between waist and hip circumferences, which is an indirect marker of intra-abdominal obesity.

The intervention program consisted on performance of exercises of the Pilates Method during the sessions of Physical Education, 32 weeks, two weekly sessions, 10 minutes.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

A history of back pain during adulthood is related to a history of back pain during adolescence. Therefore, preventing back pain in adolescents helps to prevent their appearance in adulthood. Sagittal spinal misalignments and stability of the spine are in connection with back pain in adolescents. In addition, they influence on several spinal pathologies and decrease the functional capacity and quality of life of adolescents.

Therefore, the objectives of the following project were: a) assess back pain in schoolchildren and check their relationship with quality of life, sagittal spine curvature, extensibility of the hamstring muscles, sedentary lifestyle, physical activity, BMI , percentage of body fat and the waist-hip index; b) measure the sagittal spinal curvature of the schoolchildren, the quality of life and the prevalence of physical activity among adolescents and check their relationship with the hamstring extensibility, sedentary lifestyle, the BMI , percentage of body fat and the waist-hip index; c) analyze the effect of a 10-minute Pilates program carried out in the final part of the Physical Education sessions for 4.5 months and 9 months on back pain, quality of life, sagittal spinal curvatures, the hamstring flexibility, the BMI, the percentage of body fat and the waist-hip index.

The present investigation will be elaborated by a quasi-experimental design, with experimental group (GE) and control group (CG); with pre-test, intermediate and post-test, with analysis of intra-group and inter-group measurements for each of the dependent variables selected in the study.

The inclusion criteria will be: a) being in Compulsory Secondary Education; b) not present any musculoskeletal, neurological, cardiological, metabolic, rheumatic or previous history of spinal pathologies or with previous treatment; c) be active in the sessions of Physical Education.

It was assessed back pain with Back Pain Survey in adolescents. Quality of life was assessed through the Kidscreen-27 questionnaire. To assess the sagittal spinal curvatura (in several position) the Spinal Mouse System (Idiag, Fehraltdorf, Switzerland) was used.

The extensibility of hamstring muscle was assessed with seat and reach test, toe touch test and active and passive straight leg raising test.

The sedentary lifestyle as well as the level of physical activity will be evaluated through the Adolescent International Physical Activity Questionnaire (IPAQ).

The body mass index will be obtained by recording weight and height (BMI = Weight (kg) / height (cm) 2).

The waist-hip ratio is the quotient between waist and hip circumferences, which is an indirect marker of intra-abdominal obesity.

The intervention program consisted in the realization of exercises of the Pilates Method during the sessions of Physical Education. The duration of the program will be 32 weeks, with a frequency of two weekly sessions and a duration per intervention of 10 minutes. During this time the experimental group developed the intervention program with the Pilates Method and the control group carried out their usual sessions of Physical Education . All students to be taken into account in the research must have attended and conducted the practice at least 80% of sessions. The program consisted of four Pilates exercises, planned with a basic-intermediate level, gradually incorporating the Principles of the Pilates Method and increasing the intensity of the exercises. Among these four exercises, two focus on the work of the resistance of the flexor muscles of the trunk, one in the work of the resistance of the trunk extensor musculature and another in the work of hamstring extensibility.The exercises will be performed in cool down of the sessions of Physical Education.

Study Type

Interventional

Enrollment (Actual)

286

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

11 years to 17 years (CHILD)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • be enrolled in Compulsory Secondary Education
  • be active in the sessions of Physical Education.

Exclusion Criteria:

  • presenting any musculoskeletal, neurological, cardiological, metabolic or rheumatic alteration
  • missing more than one session of the programme (91.66% attendance)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Pilates
This group is the experimental group. The intervention program consisted on performance Pilates method exercise program during the sessions of Physical Education.
The intervention program consisted in the realization of exercises of the Pilates Method. The duration of the program was 32 weeks, with a frequency of two weekly sessions and a duration per intervention of 10 minutes. During this time the experimental group developed the intervention program with the Pilates Method.
NO_INTERVENTION: Control
Adolescents assigned to the CG did not receive any structured exercise programme; they just attended their usual Physical Education sessions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change Sagittal spinal curvature
Time Frame: Change from Baseline Sagittal spinal curvature at 4,5 month and at 9 month
Sagittal spinal curvature is assess with the Spinal Mouse System. It is measure: angle of the dorsal and lumbar curve and pelvic tilt when standing, in self-correcting standing, in asthenic sitting, in maximum trunk flexion. knees flexed and extended; and maximum trunk flexion from standing. This is noninvasive technique. The result is register in grades.
Change from Baseline Sagittal spinal curvature at 4,5 month and at 9 month
Change Hamstring extensibility - active straight leg raising test.
Time Frame: Change from Baseline hamstring extensibility at 4,5 month and at 9 month
The hamstring extensibility is assessed by active straight leg raising test. This is noninvasive technique. The result is register in grades. Higher values represent a better outcome. The range could be between 0 to 180º. Normal values: between 75 to 180º; Shortness type I: between 61 to 74º; and shortness type II; less than 60º. Shortness is mean that the subject have less hamstring extensibility than the normal.
Change from Baseline hamstring extensibility at 4,5 month and at 9 month
Change Hamstring extensibility - passive straight leg raising test.
Time Frame: Change from Baseline Hamstring extensibility at 4,5 month and at 9 month
The hamstring extensibility is assessed by passive straight leg raising test. This is noninvasive technique. The result is register in grades. Higher values represent a better outcome.
Change from Baseline Hamstring extensibility at 4,5 month and at 9 month

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change Back pain, physical activity and sedentary behaviour (questionnaire)
Time Frame: Change from Baseline Sagittal spinal curvature at 4,5 month and at 9 month

Back pain, physical activity and sedentary behaviour is evaluated through the Back Pain Survey in adolescents. This questionnaire included questions about this three items.

This survey is used to know the prevalence of back pain, physical activity and sedentary time.

The survey do not includes a scale. The survey ask questions like: Did you have back pain last year that will hamper or limit activities at school or in their leisure time for more than 3 months? Yes/no ; Do you practice any sport in your free live? Yes/No

Change from Baseline Sagittal spinal curvature at 4,5 month and at 9 month
Change Quality of life: Kindscreem 27 questionnaire
Time Frame: Change from Baseline Back pain, physical activity and sedentary behaviour at 4,5 month and at 9 month

Quality of life is assessed through the Kindscreem 27 questionnaire.

To measure the quality of life related to health in adolescents with a total of 27 items assessed on the Likert Scale in the following dimensions: physical activity and health, psychological well-being, relationship with peers and autonomy, social support and peers, and the environment school. Categorizing:

Extremely difficult 27 to 54;Moderate difficulty 55 to 81;No difficulty makes 82 to 135

Change from Baseline Back pain, physical activity and sedentary behaviour at 4,5 month and at 9 month
Change Body mass index
Time Frame: Change from Baseline Body mass index at 4,5 month and at 9 month
The body mass index is obtained by recording weight and height. They will be measured with a 220k digital medical scale with height meter. The BMI will be calculated with the formula of the Quetelet Index (1869) (BMI = Weight (kg) / height (cm) 2).
Change from Baseline Body mass index at 4,5 month and at 9 month
Change Waist-hip ratio
Time Frame: Change from Baseline Waist-hip ratio at 4,5 month and at 9 month
The waist-hip ratio is the quotient between waist and hip circumferences, which is an indirect marker of intra-abdominal obesity. This is noninvasive technique.
Change from Baseline Waist-hip ratio at 4,5 month and at 9 month
Change Hamstring extensibility Seat and Reach test
Time Frame: Change from Baseline Hamstring extensibility at 4,5 month and at 9 month

The hamstring extensibility is assessed by seat and reach test. This is noninvasive test.

The result is register in centimeters. Higher values represent a better outcome.

Change from Baseline Hamstring extensibility at 4,5 month and at 9 month
Change Hamstring extensibility Toe touch test
Time Frame: Change from Baseline Hamstring extensibility at 4,5 month and at 9 month

The hamstring extensibility is assessed by toe touch test. This is noninvasive test.

The result is register in centimetres. Higher values represent a better outcome.

Change from Baseline Hamstring extensibility at 4,5 month and at 9 month
Change Level of physical activity - Adolescent International Physical Activity Questionnaire (IPAQ).
Time Frame: Change from Baseline Level of physical activity at 4,5 month and at 9 month

The level of physical activity will be evaluated through the Adolescent International Physical Activity Questionnaire (IPAQ).

It is register and summation of the duration (in minutes) and frequency (days) of walking, moderate-intensity and vigorous-intensity activities.The following values continue to be used for the analysis of IPAQ data: Walking=3.3METs (equivalent metabolic), Moderate PA (physical activity)=4.0METs (Metabolic equivalent) and Vigorous PA=8.0METs (Metabolic equivalent).

Category 1 Low: Those individuals who not meet criteria for Categories 2 or 3. Category 2 Moderate: Total physical activity of at least 600 MET-minutes/week. Category 3 High: a) Total physical activity of at least 3000 MET-minutes/week.

Change from Baseline Level of physical activity at 4,5 month and at 9 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Noelia G Gálvez, PhD., UCAM

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

September 15, 2016

Primary Completion (ACTUAL)

October 1, 2016

Study Completion (ACTUAL)

June 30, 2017

Study Registration Dates

First Submitted

January 30, 2019

First Submitted That Met QC Criteria

February 4, 2019

First Posted (ACTUAL)

February 6, 2019

Study Record Updates

Last Update Posted (ACTUAL)

February 6, 2019

Last Update Submitted That Met QC Criteria

February 4, 2019

Last Verified

February 1, 2019

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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